Gary B Davenport, MD is a medicare enrolled "Internal Medicine" physician in Mill Creek, West Virginia. His current practice location is
Us Routes 219 & 250, Mill Creek, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 335-2050.
Gary B Davenport is licensed to practice in West Virginia (license number 21118) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720074883.
Physician's Profile
Full Name | Gary B Davenport |
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Gender | Male |
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Speciality | Internal Medicine |
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Location | Us Routes 219 & 250, Mill Creek, West Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1720074883
- Provider Enumeration Date: 09/23/2005
- Last Update Date: 07/02/2010
Medicare PECOS Information:
- PECOS PAC ID: 3274429980
- Enrollment ID: I20040227000275
Medical Identifiers
Medical identifiers for Gary B Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720074883 | NPI | - | NPPES |
3004232000 | Medicaid | WV | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 21118 (West Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gary B Davenport allows following entities to bill medicare on his behalf.
Entity Name | Camden-clark Physician Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1710125430 PECOS PAC ID: 5294885661 Enrollment ID: O20090604000570 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gary B Davenport is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gary B Davenport, MD Po Box 247, Mill Creek, WV 26280-0247 Ph: (304) 335-2050 | Gary B Davenport, MD Us Routes 219 & 250, Mill Creek, WV 26280-0000 Ph: (304) 335-2050 |
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